EMR Future
What are the final details of the Meaningful use criteria?
On July 13th the long awaited final meaningful use criteria were released. Standards were relaxed to ease compliance. The new criteria states that in order to comply 15 core objectives must be met and 5 out of 10 optional menu items must be met.
AccessMD meets 11 out of 15 core objectives, 6 out of 10 menu items for hospitals and 8 out of 10 for eligible providers.
The New England Journal of Medicine has published an itemized summary of the criteria.
Electronic medical record (EMR) solutions are definitely starting to push to the forefront. However, it seems as though organizations are still struggling to evaluate the wide range of solutions available on the market to find ones to fit their environments. How can practices effectively choose the right EMR solutions?
The most important thing a practice can do is try to understand its environment, its workflow and which functionalities it needs. It should then look for vendors who cater to those specific needs, because there are many different vendors with various levels of functionality and specialty. Does that vendor address the specific needs for your specialty? If you are an ophthalmologist or a cardiologist, does that vendor have the functionality to meet your needs in that area? The size of the practice should also help determine which vendor to choose. A small practice should not go with an epic system, and a large practice should not choose a smaller vendor. Physicians have strong opinions concerning what they like and do not like. Thus, it is critical that they evaluate the EMRs so that they can observe the system and workflow firsthand. Doing site visits and having demos from the vendors is critical. A main determinant of which system is used has to do with its level of ease and efficiency.
What are the differences between EMR solutions used in large hospitals and those used in smaller physician practices? When in a smaller practice, the system does not need to address multiple specialties. Hence, the focus can be on one specialty and the system can be customized and built to serve that specific practice’s needs. Another Healthcare issue for smaller practices is cost. Smaller physician practices are looking for something that is going to help them get the job done, but also not put them in debt for the rest of their lives. The trend is leaning toward having only one vendor, so you are not dealing with one system for billing and one for EMR. Cost is still an issue for larger hospitals, but may not be as much of an inhibitor as lack of functionality and not having the resources to meet the needs of larger organizations. There are only a handful of vendors that really serve large physician practices. On the larger side, there is integration. Often, organizations want to integrate the ambulatory EMR to their in-patient EMRs in order to pass information between practices and hospitals. This is very beneficial when the physicians can use the same EMR – or even if they are using different EMR solutions – when they are connected to the hospital. When they do their rounds in the hospital, the information from the hospital can be accessed via their practice system.
How are vendors reacting to the changing needs of various organizations (scaling up, scaling down)?
Vendors are trying to deliver an application service provider (ASP) or a remote-hosted model to be able to help – especially larger practices – reach out to smaller physicians and address their needs. They are trying to deliver varying functionality at a reasonable price, so physicians in various specialties can have functionality and keep up with the incentive to have electronic practices.
Generally speaking, how mature are the solutions offered by EMR providers today? Do you believe most of the solutions available today are credible and reliable enough for physicians to use?
Most of the products available are fairly mature. Most of the EMR vendors, especially those who play on a national level, have basic functionality. This is where CCHIT has had an impact on establishing some base functionality, security and inoperability levels that have to be achieved for an EMR to have the stamp of approval. CCHIT has helped in that process and instilled confidence to physicians and organizations as they go out and purchase these solutions. They realize that the EMR has base functionality and so they are confident that it will do what the vendor states it will do. Most vendors on the national level have to keep up in terms of functionality and technology in order to maintain their market share; if they do not, they earn a bad reputation quickly. There are still many solutions, especially including some of the smaller players that have not gone to the CCHIT certification, but still provide good solutions. However, you have to be more careful because those solutions are targeted towards specific specialties or sometimes do not have the support to help grow that customer base. One thing that CCHIT certification has allowed physicians to have is a base level of confidence that there are solutions that reliably meet the needs of providers. The differentiators are how financially stable they are and the level of support you will get. Aside from having a reliable product, the relationship should entail good support and service.
Why are providers starting to automate practices? What are the benefits of automating?
Automation is something that has proven to help practices save money and time, especially in terms of how long they spend documenting information. It has also helped improve patient care and reduce errors. This is happening across the board, not only in the ambulatory side. We have seen both large and small practices run electronically. It has freed up space for them to have additional patient rooms and turn their paper record rooms into small out-patient pharmacies. There are some great benefits in an EMR. Not only does the product make a difference, but also the support, training and the relationship in general between the vendor and the provider impact how successful a provider will be with the EMR.
What is the biggest trend you see happening in the EMR space in the next few years?
First of all, more and more hospital organizations are trying to figure out how they are going to take advantage of the change and propel EMR solutions to the community physicians. Many CIOs of hospital organizations are trying to figure out how to get unknown community physicians involved in the electronic medical record in a way that is functionally rich and meets their needs, but is also priced affordably. Additionally, we will see continued acceptance or adoption of EMR solutions in the smaller practices. As a result, more small practices will be able to realize these benefit
New Administration Initiatives:
The American Recovery and Reinvestment Act of 2009, signed by President Obama on February 17, 2009, includes $19.2 billion in provisions for healthcare information technology (health IT). In its role as the leading authority on the appropriate implementation and use of Health IT, HIMSS has multiple resources to equip its members for ARRA. The Society educates and connects healthcare professionals through IT tools, resources, research, education and networking. Come back often to get the latest news, information and answers on economic stimulus and the impact of this momentous act on our industry.U.S. Senator Barack Obama (D-IL) today said the Senate’s passage of the Wired for Health Care Quality Act (S. 1418) will help cut health care costs, improve the quality of care and modernize the health care industry. The legislation is cosponsored by Senator Obama and passed the Senate unanimously. It is estimated that the nation would save $140 billion per year from proper use of internet technology in the health care system, 11/18/08
Dr. Brian Klepper, principal of Health 2.0 Advisors in San Francisco, says that patients have the ability to fully engage in their health care through an EMR. Klepper also owns WeCare TLC, a small business that provides employers with on-site health care clinics and access to EMRs. The bare-bones interface allows a patient to schedule a visit, get reminders about annual check-ups and special exams or review lab test results--explanation of medical terminology included.
A spokesman for the company says that its clients save 15% to 25% of their annual health care costs by paying a flat yearly fee for clinic services. It currently serves 9,000 individuals and operates four clinics in Florida and Georgia.
By scale, WeCare TLC is a tiny player in an industry that includes Google and Microsoft, both of which have launched their own EMR programs. In fact, the breadth of the market raises the question about how patients will have access to uniform and interoperable EMRs--a question that will likely be resolved through financial incentives to health providers to adopt health IT.